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170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Preventive medicine perhaps achieved its earliest and most complete successes in the field of pediatrics. Work on the problems of main concern in the last third of the century has reached a stage where preventive medicine has virtually mastered those of nutrition and infection in our countries. The current problems are malformation, accidents, and suicide, and this has meant a major shift of interest for preventive activity. In some fields, prevention-detection of neonatal affections takes place in the prenatal period: here, the pediatrician joins hands with the geneticist and the obstetrician. In other fields, such as accident prevention, the pediatrician's role is of particular importance to the authorities, industry, and the family. Finally, and this is new, the pediatrician is responsible for the prevention of diseases occurring in the adult. His role in this was a matter of course in nutritional diseases such as malnutrition and rickets, and in infections such as tuberculosis. It is assuming increasing importance in the detection and prevention of certain risk factors and common affections of the adult such as obesity, hypertension and atheroma.
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PMID:[Current aspects and prospects of preventive pediatrics in France]. 65 40

A case of phaeochromocytoma which presented with hypertension and severe psychiatric disturbances including three attempts at suicide. These psychiatric problems regressed completely following removal of the tumour. Although inconstant, the combination of hypertension and psychiatric problems should always lead to studies for the possible presence of a phaeochromocytoma. The mechanism of these disturbances is not clearly understood but either a direct action of catecholamines on cerebral tissue or changes secondary to blood pressure variations are suggested.
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PMID:[Phaeochromocytoma with psychiatric disturbances. One case (author's transl)]. 67 92

The causes of mortality and frequency of diseases were tabulated in 304 autopsies performed at Hopital Mama Yemo, Kinshasa, between July 1973 and December 1974. 78 of these autopsies were performed on subjects who died at Hopital Mama Yemo, 36 encompassed subjects from other hospitals, and 190 were of medicolegal cases in which the cause of death was not apparent from external examination. Men comprised 63.5% of autopsied cases. The mean age was 30.19 +or- 1.31 for men and 19.84 +or- 1.76 for women. 16.8% of deaths were due to homicide, 6.3% to suicide, and 8.9% to accidents, yielding an overall prevalence for trauma of 32%. Cancer accounted for only 3% of deaths, and cardiovascular diseases 8.2%. Bacterial infections (predominantly streptococcal disease, lobar pneumonia, and pulmonary tuberculosis) represented the largest single cause of death (17.4%). Parasitic infections comprised a further 6.3% of mortality and viral infections 7.2%, giving infectious diseases a combined frequency of 30.9%. Metabolic diseases were responsible for an additional 11.8% of deaths. Obstetric causes were identified in 3.9% of fatalities, and 95% of these cases represented hemorrhagic and septic complications of illegal abortion. Neonatal deaths (4.3%) were largely due to pneumonitis from aspirated amniotic fluid. A final 5.9% of deaths were unexplained. Also analyzed were cases of sudden death occurring outside the hospitals. 31.3% of these deaths were attributed to cardiovascular diseases and 46.3% to infection (including 2.5% due to septic abortion). Finally, the frequency of major diseases in this series was tabulated. Malaria was most frequently found (41.8%), followed by intravascular erythrocytic sickling (18.3%) and hypertension (16%). 12% of females in this series (20% of those dying traumatically) showed evidence of pelvic inflammatory disease. This series is considered to overestimate the frequency of trauma because of the large number of medicolegal cases that fall in this category. This selection for trauma further led to an oversampling of adult men. Nonetheless, it represents the 1st and best qualitative estimate of disease mortality and prevalence in Zaire. The trends in mortality and morbidity identified through this study provide a basis for planning health care and health education.
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PMID:Autopsy analysis of disease frequency in Kinshasa, Republic of Zaire. 96 86

The youthful habits and family attitudes of medical students who later developed or died from one of five disease states were different from those of healthy classmate controls to begin with. In medical school, the total disorder group had significantly more nervous tension, anxiety, and anger under stress, had more insomnia, smoked more cigarettes, and took alcoholic drinks more frequently. Individual disorder group means were significantly different from each other. The mental illness group showed the most nervous tension, depression, and anger under stress and the malignant tumor group the least. The malignant tumor group resembled the healthy control group in these respects. The suicide, mental illness, and malignant tumor groups had low mean scores for closeness to parents, while the hypertension and coronary occlusion group means were slightly higher than the control group mean. Thus psychologic differences in youth have predictive potential in regard to premature disease and death.
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PMID:Precursors of premature disease and death. The predictive potential of habits and family attitudes. 98 20

To test the hypothesis that human figures drawn by young adults are potential predictors of future disease states, drawings of 204 former medical students were examined 13 to 23 years later. During the interval, the 102 subjects in the experimental group developed one of six specified disorders, while the 102 subjects in the control groups remained in good health. Drawings were classified in eight categories based primarily on the stance of the figure. Categories of drawings found to be distinctive for the various groups are: healthy control groups: the neutral or uncommitted attitude; hypertension/coronary group: the inviting or input-demanding attitude; malignant tumor group: the attitude of ambivalence or conflict; suicide/mental illness group: the self-related or withdrawal attitude; emotional disturbance group: incomplete figures, bizarre figures, action scenes. Thus the evidence suggests that the stance of the figure drawing reflects the subject's attitude toward the outside world. When the category profiles of groups are compared, the following differences are found at levels of statistical significance: the total experimental group is different from the total control group; the somatic subset, "Body Takes the Rap" is different from the psychological subset, "Psyche Takes the Rap"; and the hypertension/coronary group, malignant tumor group, and emotional disturbance group are different from their specific control groups. It is concluded that human figure drawings by this population have predictive potential for certain future disease states, and that there are psychological precursors of somatic disease.
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PMID:Human figure drawings in a prospective study of six disorders: hypertension, coronary heart disease, malignant tumor, suicide, mental illness, and emotional disturbance. 110 Jul 80

Post-traumatic stress disorder (PTSD) was studied in the Piedmont region of North Carolina. Among 2985 subjects, the lifetime and six month prevalence figures for PTSD were 1.30 and 0.44% respectively. In comparison to non-PTSD subjects, those with PTSD had significantly greater job instability, family history of psychiatric illness, parental poverty, child abuse, and separation or divorce of parents prior to age 10. PTSD was associated with greater psychiatric comorbidity and attempted suicide, increased frequency of bronchial asthma, hypertension, peptic ulcer and with impaired social support. Differences were noted between chronic and acute PTSD on a number of measures, with chronic PTSD being accompanied by more frequent social phobia, reduced social support and greater avoidance symptoms.
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PMID:Post-traumatic stress disorder in the community: an epidemiological study. 194 60

The impact, time trends and potential for prevention of premature deaths in Canada were assessed. There were almost 100,000 deaths before age 75 in Canada during 1986 resulting in over 1.7 million potential years of life lost (PYLL). The three leading broad disease categories responsible for PYLL were cancer, injuries/violence and cardiovascular disease. In both sexes, coronary heart disease, car accidents, lung cancer and perinatal conditions ranked in the top 5 specific diseases responsible for PYLL; breast cancer (females) and suicide (males) also ranked in the top 5 conditions. Over the period 1969 to 1986, death rates among persons less than age 75 increased for 3 conditions among females and 11 conditions among males. Lung cancer and brain cancer death rates increased in both sexes, chronic obstructive pulmonary disease death rates increased among females only and death rates for suicide and 8 types of cancer increased among males only. Over the same period, death rates declined for 37 discrete disease categories among both females and males including particularly large improvements for coronary heart disease, stroke, car accidents and perinatal conditions. An estimated 50,000 or over 50% of all premature deaths per year are preventable through control of smoking, hypertension, elevated serum cholesterol, diabetes and alcohol abuse. About 6,000 premature deaths are avoidable through improvements in medical care.
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PMID:Premature deaths in Canada: impact, trends and opportunities for prevention. 225 55

19-Nor-deoxycorticosterone (19-nor-DOC) is a mineralocorticoid that is increased in some forms of experimental and human hypertension. The pivotal step in 19-nor-DOC biosynthesis is adrenal P450 19-hydroxylase, but this enzyme has not been clearly distinguished from P450 11 beta/18-hydroxylase. This study attempted to specifically inhibit adrenal 19-hydroxylation of deoxycorticosterone (DOC) using a suicide aromatase inhibitor, 19-acetylenic androstenedione (19-AA). Purified bovine P450 11 beta/18/19-hydroxylase was incubated with excess substrate DOC, adrenodoxin, and adrenodoxin reductase in the presence of increasing doses of the inhibitor, 19AA. 11 beta-, 18-, and 19-hydroxylation were measured by quantification of corticosterone, 18-OH-DOC, and 19-OH-DOC respectively. Measurements of these products demonstrated that 11 beta- and 18-hydroxylation was not inhibited whereas 19-hydroxylation was inhibited as manifested by decreased 19-OH-DOC formation (p less than .05). The IC50 of 19-AA was approximately 10(-12) M. The specific inhibition of 19-hydroxylation suggests that the 19-hydroxylase may be an enzyme distinct from the P450 11 beta/18-hydroxylase. This further suggests that 19-nor-DOC biosynthesis may be under independent regulation and may be amendable to specific in vivo inhibition.
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PMID:19-Hydroxylase inhibition of adrenal mitochondrial P450 11 beta/18/19-hydroxylase by a suicide inhibitor. 278 64

A case of cerebral oedema developed during an apparently common attempted suicide with valpromide is reported. The most conspicuous biochemical abnormality was hyperammonaemia. The oedema proved refractory to the standard medical treatment of intracranial hypertension, and decompressive craniectomy was performed with only minor sequelae. The cerebral oedema cum hyperammonaemia syndrome led to the discovery, in this hitherto asymptomatic adult subject, of a 50 per cent deficiency in type a carbamyl phosphate synthetase liver activity. By completing such a deficiency, valproate may produce an extremely serious syndrome resembling the neonatal encephalopathy due to complete enzyme deficiencies in the urea cycle. All valpromide or valproate intoxications probably are cerebral oedemas with hyperammonaemia akin ti Reye's syndrome. All accidents of this type occurring during treatment or poisoning with valproate should be investigated for urea cycle enzyme abnormalities.
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PMID:[Cerebral edema with hyperammonemia in valpromide poisoning. Manifestation in an adult, of a partial deficit in type I carbamylphosphate synthetase]. 297 63

From March 1967 to February 1985, ninety one patients aged from eleven months to 53 years underwent surgical treatment of isolated coarctation of the aorta. On reviewing the long term results it was found that persistence of hypertension was related to the age when the operation was performed. Dividing the patients into three age groups; group I: 0-5 years, group II: 6-15 years and group III: over 15 years, it was found that there was no late hypertension in group I while hypertension persisted in 11% in group II and 25% in group III. Fifty per cent of the patients with persistent hypertension were above the age of 20 years at the time of operation. The need for graft replacement was related to age of the patients and to the anatomy of the coarctation being used more frequently in older patients and in those where the coarctation was at the junction of the arch and the descending aorta or proximal to that site. Because of this relationship to the anatomy, the coarctations were classified into 4 types. The surgical procedures performed were: resection with end to end anastomosis, resection with replacement by a tube graft, patch and bypass grafts, in descending order of frequency. Eighty six patients have been followed up (mean 10 years). There was no hospital or late mortality (one patient committed suicide one year after operation) and none of the patients suffered from spinal cord injury. There were three recurrent coarctations in patients who had primary reconstruction under one year of age.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Isolated coarctation of the aorta: surgical treatment and late results. Eighteen years' experience. 318 17


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